Organization
SMILE BRILLIANT VENTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BLUESTONE (BUSINESS OWNER)
(314) 409-3598
Entity
Organization
Contact information
Practice address
1645 HEADLAND DR, FENTON, MO 63026-2836
(855) 944-8361
Mailing address
1645 HEADLAND DR, FENTON, MO 63026-2836
(855) 944-8361
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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